JP2020505140A - Hip endoprosthesis system - Google Patents

Abstract

An endoprosthesis system including a medical device for withdrawing an implanted endoprosthesis stem of a prosthesis from a patient's femur, wherein the medical device houses a connecting cone protruding from the prosthesis stem. In order to improve a hip endoprosthesis system having a connector with a connecting recess for the prosthesis in such a way that the prosthetic stem can be withdrawn simply and reliably from the patient's femur, said connector comprises: It is proposed to include a connecting base and a connecting insert that is housed in the receiving of the connecting insert of the connecting base and defines the connecting recess.

Description

  The present invention is an endoprosthesis system including a medical device for withdrawing an implanted endoprosthesis stem of a hip prosthesis from a femur of a patient, wherein the medical device protrudes from the prosthesis stem. A hip endoprosthesis system having a connector with a connector recess for receiving a body.

  Over the years, hip joints have been replaced with endoprostheses to treat damaged hip joints. This inserts the prosthesis stem into the femoral cavity prepared for it. For example, artificial joint stems having protruding connecting cones that can be connected to a neck extension or a joint head are known. A further component of the endoprosthesis is the glenoid that is secured within the patient's pelvic bone. Optionally, the acetabulum can accommodate a joint insert that forms a sliding pair with the joint head that is as wear resistant as possible.

  If an oversized or oversized prosthetic stem is inserted into the prepared bone cavity, for example during the course of an operation for implanting an endoprosthetic hip, the prosthetic stem must be removed. For this purpose, a medical device is used that has a connector that can be connected to the connecting cone of the artificial joint stem. One problem here is that, in particular, the connecting cone can be damaged when cooperating with the connector of the medical device. This is completely undesirable, since the connecting cone can no longer be reliably connected to the neck piece or the joint head if damaged. Thereby, the connection between the connecting cone and the neck piece or the joint head is created by an automatic lock. For this purpose, surfaces that optimally match each other are required. Scratches and ridges on the connecting cone prevent a secure self-locking connection.

  Accordingly, it is an object of the present invention to improve an endoprosthesis system of the type described at the outset in such a way that a prosthetic stem can be simply and reliably extracted from a patient's femur.

  This object is achieved according to the invention in a hip endoprosthesis system of the type described at the outset, in which the coupling body is received in a coupling base and in a coupling insert receiver of the coupling body to define the coupling recess. This is achieved in that it includes a coupling insert.

  A further development proposed according to the invention of a medical device of the type described at the outset makes it possible in particular to define the connection recess with a material that is softer than the connection cone of the artificial joint stem. . Thus, damage to the connecting cone can be prevented in a simple and reliable manner. By forming the connecting body into at least a two-part configuration including a connecting base and a connecting insert, it is possible to form the connecting insert and the connecting base, which are optionally made of different materials. Thus, the connection insert can be formed from a material that, in particular, would minimize the risk of damage to the connection cone. On the other hand, in order to transmit the force to be applied to pull out the artificial joint stem and to introduce the force to the connection cone, the connection base may have a sufficiently stable configuration.

  The connection base is preferably formed of a material harder than the connection insertion portion. Therefore, when the connecting cone can contact and cooperate only with the connecting insertion portion, damage to the connecting cone of the artificial joint stem by the connecting body can be minimized. For example, the connecting cones can be formed from implant steel or, in particular, from titanium or a titanium alloy. In that case, the connection insertion part is preferably formed from a material that is softer than the material from which the connection cone is formed.

  In order to ensure sufficient stability of the medical device, it is advantageous if the connecting body is made of metal. In particular, the connecting body can be formed from tool steel, for example from a cobalt chromium alloy.

  If the connecting insert is formed from plastic, the endoprosthesis system can be configured in a simple and inexpensive manner. In particular, the plastic can be polyetheretherketone (PEEK) and / or polypropylene (PP) and / or polyphenylenesulfone (PPSU). The plastics mentioned can be simply and safely sterilized, and while these plastics are sufficiently soft to prevent damage to the connecting cone, the prosthesis can be pulled out of the femur. Is sufficiently dimensionally stable to allow the necessary forces to be transmitted to the prosthetic stem.

  Preferably, the medical device includes at least one first connection element for connecting to a device handle. This makes it possible in particular to configure the coupling in the form of a regulator, also called a pull-out regulator, and to be able to couple the regulator to the instrument handle. Thus, it is possible to provide a plurality of connections, in particular with connection recesses of different dimensions and different shapes, but with only one instrument handle. In doing so, the surgeon may, for example, select the appropriate coupling and engage the coupling with the coupling cone of the artificial joint stem, and then couple the coupling to the instrument handle to connect the artificial joint stem Can be pulled out. Thus, a modular endoprosthesis system can be formed, which requires a minimal number of components to extract a number of different prosthetic stems.

  If the first connection element is configured in the form of a connection projection, the connection base can be formed in a simple manner. The connecting projections can be accommodated, for example, by corresponding connecting element receivers on the instrument handle.

  The medical device preferably includes a device handle. The instrument handle can be formed in particular as an integral part of the connecting body. Alternatively, as described, the instrument handle may be temporarily connectable to the connection substrate. For example, the instrument handle can be configured in the form of a file handle. In particular, the rasp handle may be configured as described in DE 10 2008 064518 A1. The instrument handle can be particularly connected to a file to form a surgical file. A cavity in the femur can be prepared with the file prior to inserting the prosthetic stem of the endoprosthesis. Once the bone cavity is prepared in the desired manner, the file handle can be separated from the file. Then, the connection base can be connected to the file handle, for example, by engaging the file handle with the first connection element. As a result of this modular design, the number of instruments required for implantation of a hip endoprosthesis can be further minimized.

  Advantageously, the instrument handle comprises a striker with a striking surface, the striker being located or formed at the proximal end of the instrument handle or forming the proximal end of the instrument handle. When the instrument handle is connected to the connecting body by acting on the hitting surface of the hitting body, for example, with a hammer, the artificial handle connected to the medical instrument via the connecting body from the instrument handle. A force shock can be transmitted to the joint stem to release the prosthetic stem from the femoral shaft or loosen the connection between the prosthetic stem and the patient's thigh.

  Wherein said instrument handle includes at least one second connection element for engaging in a force-locked and / or positive-lock manner in a connection position with said at least one first connection element. The connection can be connected in a simple manner. In particular, the first connection element and the second connection element are formed corresponding to each other, and are optimally connected to each other.

  The at least one second connection element is preferably configured in the form of a connection element receiver for receiving the at least one first connection element. It is advantageous to provide a connection element receiver, especially if the first connection element is configured in the form of a connection projection corresponding to the connection element receiver.

  Particularly for minimally invasive surgical intervention, it is advantageous if the at least one second coupling element is arranged or formed at the distal end of the instrument handle or forms the distal end of the instrument handle. Thus, the instrument handle can be engaged with the connector in a simple and secure manner.

  The coupling recess is preferably configured to receive the coupling cone in a force-locked and / or positive-locked manner. Therefore, a stable connection between the connecting body and the connecting cone of the artificial joint stem can be formed, thereby making it easier to pull out the artificial joint stem from the femur.

  According to a further preferred embodiment of the invention, the connecting recess is formed by connecting the connecting cone in a direction transverse to a longitudinal axis defined by the connecting cone, in particular in an insertion direction running perpendicularly. Having a lateral insertion opening for insertion into the interior can be realized. In particular, the longitudinal axis can be defined by an axis of symmetry of the connecting cone. Therefore, guiding the medical device with the connection body next to the connection cone, and then pushing the medical device over the connection cone in the insertion direction, and housing the connection cone in the connection recess. Can be.

  It is furthermore advantageous if the connecting recess has a lower insertion opening which is open in a direction transverse to the insertion direction, in particular in a direction perpendicular to the insertion direction. The lower insertion opening makes it possible not to have to separate the artificial joint stem from the connecting cone, in particular for withdrawing the artificial joint stem. When the medical device is engaged with the connecting cone of the artificial joint stem, in particular, the connection area on the artificial joint stem can pass through the lower insertion opening. The connection area connects the connecting cone to the actual shaft of the artificial joint stem. In particular, the shaft, the connection area and the connecting cone can be formed as an integral part forming the artificial joint stem.

  The coupling base surrounds the coupling insertion portion in such a way that the side insertion opening and the lower insertion opening are freely accessible when the coupling insertion portion is inserted into the coupling insertion portion receiver. This is more advantageous. Therefore, the connection cone can be inserted into the connection recess, but can contact only the connection insertion portion, and cannot contact the connection base. Therefore, it is possible to prevent the connection cone from being damaged by the connection base.

  The connecting insert preferably defines an edge or transition area that defines the side insertion opening and / or the lower insertion opening. Therefore, especially when inserting the connection cone into the connection recess, the connection cone can contact only the connection insertion portion, thereby ensuring that the risk of damage to the connection cone can be minimized. become.

  In order to achieve a particularly good transfer of force between the medical instrument and the artificial joint stem, it is advantageous if the connecting recess has an inner contour at least in part in the form of an inner cone. In order to at least partially achieve the surface contact of the connecting cone with the connecting recess, the inner cone can in particular be formed corresponding to the connecting cone.

  If the inner cone defines a longitudinal cone axis passing through the lower insertion opening, the connector may be connected to the connecting cone in a simple manner.

  Especially when the cross-section of the inner cone increases in the direction towards the lower insertion opening, a connecting cone that tapers away from the artificial joint stem can be engaged with the connector.

  In particular, it is advantageous if a narrow section is formed between the inner cone and the lower insertion opening so that the medical instrument can exert a tensile or compressive force on the artificial joint stem. is there. The cross-sectional narrowing can be engaged in particular in the transition area between the connecting cone and the shaft of the artificial joint stem, the transition area being configured in the form of a constriction. it can. As a result, in particular, the narrowing of the cross section on the connector can be laterally inserted into the constriction on the artificial joint stem. The cross-section narrowing can be configured, for example, in the form of an annular projection pointing in the direction of the longitudinal cone axis, the annular projection not being completely closed by itself.

  Advantageously, said coupling insert receiver has a lateral coupling insert receiving opening and a lower coupling insert receiving opening. Therefore, the connection insertion portion can be inserted into the connection insertion portion receiver through the side connection insertion portion receiving opening. The lower connection insert receiving opening allows, in particular, the lower insertion opening of the connection insert to remain freely accessible.

  The side coupling insert receiving opening is preferably configured such that the coupling insert is inserted into the coupling insert receiver. Thus, the connection insert and the connection base can be engaged with each other in a simple and reliable manner.

  In particular, in order to be able to transmit the tensile force of the medical device to the artificial joint stem, an under-section formed by reducing the free cross section of the connecting insert receiver in the direction towards the lower connecting insert receiving opening. It is preferred that the connection insert receiver has a cut. Thus, in particular, a force in the axial direction, that is, a force particularly parallel to the longitudinal cone axis, is transmitted from the connecting base to the connecting insert without the connecting insert being released from the connecting base. be able to.

  The connecting insert is preferably retained in the connecting insert receiver in a force-locked and / or positive-lock manner. This makes it possible to separate the connecting insert from the connecting base, in particular for cleaning the medical device, for example.

  According to a further preferred embodiment of the present invention, the medical device comprises a connecting device for connecting the connecting insert and the connecting base in a connecting position in a force-locking and / or positive locking manner. Can be realized. By using the connection device, it is possible to ensure a specific connection between the connection insertion portion and the connection base.

  If the connection device is configured in the form of a latching or snap connection device, the endoprosthesis system can be configured in a simple and inexpensive manner.

  The connection device includes first and second connection elements formed on the connection insertion part on the one hand and on the connection base on the other hand, wherein the first connection element and the second connection element are in the connection position. Can be configured in a simple manner when engaged in a force-locking and / or positive locking manner.

  Advantageously, the first connection element is configured in the form of a connection element recess and the second connection element is configured in the form of a connection protrusion. In particular, the first connection element and the second connection element are formed corresponding to each other. These connecting elements can also be selectively formed on the connecting base and on the connecting insert.

  Preferably, the first and / or the second connection element extends parallel or substantially parallel to the side connection insertion part receiving opening and / or the side insertion opening. This can be understood in particular in that the lateral insertion opening defines an insertion opening surface, and the connecting element extends parallel to this insertion opening surface. This has the advantage that the connecting insert cannot move from the connecting insert receiver without additional withdrawal forces, especially as a result of the connecting elements being engaged with each other. Therefore, in particular, the connection element extends in a direction crossing the insertion direction, and can prevent relative movement between the connection insertion portion and the connection base.

  The medical device is configured in a simple manner if the connection elements formed in the connection insert receiver on the connection body are arranged or formed so as to face in the direction of the lower connection insert receiver opening. can do. For example, the connection element can be configured as a connection projection or as a connection element receiver, for example as a rib or a groove.

  In order for the medical device to be able to be used, especially in the case of minimally invasive surgery, the first connection element is oriented on the connection base in a direction opposite or substantially opposite to the lower connection insert receiving opening. Advantageously, they are arranged in a manner. For example, the first connection element is configured in the form of a connection protrusion that protrudes from the connection base and faces in a direction opposite to a direction in which the lower connection insertion portion receiving opening is open.

  According to a further preferred embodiment of the present invention, it is provided that the hip prosthesis system comprises a release device for releasing the connecting insert from the connecting insert receiver of the connecting base. it can. The release element makes it possible to separate the connecting insert and the connecting body from each other, in particular for cleaning and sterilizing the connecting insert and the connecting body.

  Preferably, the release device includes a release member, the coupling base includes a release member opening, and the release member has a length greater than a thickness of the connection base in the area of the release member opening. In particular, by inserting the release member into the opening of the release member, the release member is adapted to apply a compressive force to the connecting insertion part, preferably in a direction parallel to the insertion direction. This configuration allows for the possibility of projecting into the receiving section, whereby the connecting inserts can be pushed or pressed respectively from the connecting insert receivers. Thus, in particular, the force required to release the connecting device, that is, the force required to disengage the mutually engaged first connection element and the second connection element, is applied to the connection insertion portion. Can be transmitted.

  If the release member opening is arranged or formed on the opposite side of the side connecting insert receiving opening, the connecting insert can be released from the connecting base in a particularly simple manner. Therefore, the connection insertion part can be pressed directly from the connection insertion part receiver through the side connection insertion part receiving opening.

  If the release member is configured in the form of a release pin projecting from the release element, the release element can be configured in a simple manner.

  If the release member comprises a male screw and the release member opening comprises a female screw corresponding to the male screw, the force acting between the engaged connecting elements of the connecting device can be overcome in a particularly easy manner and the coupling insert can be used. And the connecting base can be released from each other. Thus, the release member can be screwed into the release member opening, whereby the release force can be transmitted to the connecting insert in a very regulated manner.

  According to a further preferred embodiment of the present invention, it is provided that the endoprosthesis system comprises a prosthesis stem of an endoprosthesis, wherein the prosthesis stem has a protruding connecting cone. it can. In particular, the hip endoprosthesis system may include a plurality of different prosthetic stems of that type. The endoprosthesis system can include a corresponding connector suitable for each connecting cone of the prosthetic stem, and can form a modular endoprosthesis system.

  The following description of the preferred embodiment of the present invention serves to further explain it in conjunction with the drawings.

1 is an overall perspective view of a hip endoprosthesis system according to the present invention. FIG. 2 is a partial cutaway view of the arrangement of FIG. 1 along line 2-2. The side view of the connection body connected to an artificial joint stem. FIG. 3 is an exploded view of the artificial joint stem, the connection base, and the connection insertion portion. FIG. 5 is a sectional view taken along lines 5-5 in FIG. 3; FIG. 10 is a partially broken side view of the connection body when the connection insertion portion is released from the connection base using the release element.

  FIG. 1 schematically depicts a first embodiment of a hip endoprosthesis system, generally designated by the reference numeral 10. The endoprosthesis system includes a medical device 12 for withdrawing an artificial joint stem 14 of an implanted endoprosthesis 16 from a patient's femur.

  Optionally, the endoprosthesis system 10 further includes a prosthetic stem 14 and, optionally, an instrument handle 18. The instrument handle 18 can be configured in particular in the form of a file handle 20, as described for example in DE 10 2008 064 518 A1.

  The instrument handle 18 has a striking body 22 at its proximal end with a striking surface 24 that faces proximally and is slightly convexly curved away from the instrument handle 18. The striker thus forms the proximal end of the instrument handle 18, as depicted for example in FIG.

  The instrument handle 18 has an elongated curved instrument 26 that extends from the striker 22 to a distal end 28 of the instrument handle.

  The prosthetic stem 14 includes an elongate shaft body 30 that tapers in cross section toward a distal end 32.

  From the proximal end 34 of the shaft body, a connecting cone 38 projects in an inclined manner with respect to the end face 36 of the shaft body 30. The connecting cone 38 is configured in the form of a truncated cone having a tapered cross section in the direction toward the circular end face 40 facing away from the shaft body 30.

  Connected to the distal end 42 of the connecting cone 38 is a short neck section 44, which has a reduced cross section at the distal end 42 of the connecting cone 38, thus connecting the connecting cone 38 and the shaft body. A stenosis is formed between the stenosis and the stenosis.

  The connecting cone 38 serves to connect to a joint head (not shown) in the hip endoprosthesis 16. The joint head has a receiving cone corresponding to the connecting cone 38 so that the artificial joint stem 14 and the joint head can be connected to each other by automatic locking. Optionally, if desired, the connecting cone 38 can be connected to the extension zone in the manner described for the joint head, and the extension zone can be connected to the joint head. The extension area is not shown.

  If the prosthetic stem 14 is inserted into the patient's femoral cavity prepared for it, but does not fit as desired by the surgeon, the prosthetic stem 14 must be withdrawn from the femur again. The device 12 serves this purpose. The device 12 is configured in the form of a two-part pullout adjuster 46 and serves as a connector 48 with a connection recess 50 for receiving a connection cone.

  The link 48 includes a link base 52 with a link insert receiver 54 in which a link insert 56 is housed in a force-lock and / or positive lock manner. The connection concave portion 50 is formed on the connection insertion portion 56.

  The connection base 52 is formed of a material harder than the connection insertion portion 56. For example, the connecting body 52 can be formed from metal, particularly instrument steel.

  The connecting insert 56 is preferably formed from a material that is softer than the material from which the prosthetic stem 14, in particular its connecting cone 38, is formed. Thus, the risk of damaging the connecting cone 38 when received in the connecting recess 50 of the pull-out adjuster 46 can be minimized. The coupling insert 56 is preferably formed from plastic. For example, the plastic can be polyetheretherketone (PEEK), polypropylene (PP), and / or polyphenylene sulfone (PPSU). PEEK here has in particular the most relevant mechanical material reference values, in particular tensile and compressive strength, hardness, and modulus.

  A first connecting element 60 is disposed or formed on the connector 48 at the proximally facing end face 58 to enable the device 12 to be connected to the device handle 18. Said connecting element 60 can be configured in the form of a connecting projection 62 defining a connecting projection longitudinal axis 64 running in a direction intersecting, in particular perpendicular to the end face 58, as schematically depicted in particular in the figures. A concave portion 66 defining an undercut is formed laterally on the connecting protrusion 62.

  A second connecting element 68 corresponding to the first connecting element 60 is formed on the instrument handle 18 for engaging in a force-locking and / or positive locking manner in the connecting position with the first connecting element 60. . The first connecting element 60 is depicted, for example, in FIGS. The second connection element 68 is configured in the form of a connection element receiver 70 for receiving the first connection element 60. The coupling element receiver 70 is formed corresponding to the coupling projection 62 and accommodates the coupling projection in a positive-lock or substantially positive-lock manner.

  Securing the pullout adjuster 46 to the instrument handle 18 is on the instrument handle 18 such that it is pivotable about a pivot axis 74 that runs transversely to the coupling projection longitudinal axis 64. The pivotable fixing member 72 is attached to the fixing member 72. The distal end of the anchoring member 72 is pivoted into the recess 66 in the locked position, for example, as depicted in FIG. 2, and is released in the released position where the instrument handle 18 can be removed from the pullout adjuster 46. It is configured in the form of a locking projection 76 which is pivoted to.

  An anchoring member 72 is connected to a corresponding pivot mechanism on the instrument handle 18 and is pivoted about a pivot axis 74 to connect to or release from the first connection element 60. . In particular, the pivoting mechanism can be configured as described in DE 10 2008 064 518 A1.

  The second connecting elements 68 are respectively located at or form the ends 28 of the instrument handle 18.

  The coupling recess 50 is configured to receive the coupling cone 38 in a force-locked and / or positive-lock manner. The coupling recess has a lateral insertion opening 78 for pushing the coupling cone 38 into the coupling recess 50 in the insertion direction schematically indicated by the arrow 80 in FIG. The insertion direction 80 runs in a direction perpendicular to the longitudinal axis 82 defined by the connecting cone 38, particularly perpendicularly.

  The coupling recess 50 further has a lower insertion opening 84 that opens in a direction perpendicular to the insertion opening 80, particularly in a direction perpendicular to the insertion opening 80.

  The coupling base 52 is configured in a shell-like manner or in the form of a shell, with the side insertion opening 78 and the lower insertion opening 84 being freely accessible when the coupling insert 56 is received in the coupling insert receiver 54. Surround the connection insertion portion 56 in such a manner as follows. This configuration can be easily seen in particular in FIGS.

  The coupling insert 56 defines a side insertion opening 78 and an edge 86, and an edge 88 defining a lower insertion opening 84, respectively.

  The coupling recess 50 has an inner contour 90 that at least partially has the form of an inner cone 92.

  Inner cone 92 defines a longitudinal cone axis 94 passing through lower insertion opening 84. The inner cone 92 has a cross section that increases further in the direction toward the lower insertion opening 84.

  The coupling recess 50 is further configured in such a way that a narrow section 96 is formed between the inner cone 92 and the lower insertion opening 84. As the prosthetic stem 14 is connected to the pullout adjuster 46, the cross-sectional narrowing 96 engages into the neck section 44 between the connecting cone 38 and the shaft body 30. The narrow cross section 96 forms a so-called annular projection that is convexly curved in the direction toward the longitudinal cone axis 94.

  The connection insertion portion receiver 54 has a side connection insertion portion receiving opening 98 and a lower connection insertion portion receiving opening 100. The connecting insert 56 can also be pushed into the connecting insert receiver 54 in the insertion direction 80 through a correspondingly formed side connecting insert receiving opening 98.

  Acting axially in the coupling insert receiver, i.e. in parallel with the longitudinal cone axis 94, to secure the coupling insert 56 is a proximally facing annular surface 104 which is not closed by itself. The undercut 102 is defined. The undercut 102 is formed by reducing the free cross section of the connection insertion portion receiver 54 in the direction toward the lower connection insertion portion receiving opening 100.

  The outer contour of the coupling insert 56 substantially matches the inner contour of the coupling insert receiver 54, and the coupling insert 56 is retained within the coupling insert receiver 54 in a force-locked and / or positive lock manner. You.

  A connection device 106 is provided on the medical device 12 for fixing the connection insertion portion 56 in the connection insertion portion receiver 54 against movement opposite to the insertion direction 80, and the connection insertion portion 56 and the connection base 52 are provided. Are connected to one another in a force-locking and / or positive-locking manner, for example in the connection position depicted in FIG.

  The connection device 106 can be configured, in particular, in the form of a latching or snap connection device 108.

  The connection device 106 includes a first connection element 110 and a second connection element 112 arranged or formed on the connection base 52 on the one hand and on the connection insert 56 on the other hand. The connecting element 110 and the connecting element 112 are engaged in a force-locking and / or positive locking manner in the connecting position.

  The first connection element 110 is configured in the form of a connection element recess 114. The second connection element 112 is configured in the form of a connection protrusion 116.

  The connection elements 110 and 112 extend parallel to an opening surface 118 defined by the side connection insert receiving opening 98 and also by the side insertion opening 78.

  Each of the connection element recesses 114 having a long rectangular parallelepiped configuration is arranged or formed so as to face the direction toward the lower connection insertion portion receiving opening 100.

  Further, the lower connection insertion portion receiving opening 100 opens in a direction opposite to the direction defined by the first connection element 60.

  The hip prosthesis system 10 can further include a release device 120 for releasing the connecting insert 56 from the connecting insert receiver 54 of the connecting base 52. The release device includes a release member 122.

  A release member opening 124 is formed on the connecting base 52. In the area of the release member opening 124, the length 126 of the release member 122 is greater than the thickness 128 of the connecting base 52. The release member openings 124 are respectively disposed or formed on the opposite sides of the side connection insertion portion receiving openings 98.

  The release member 122 is configured in the form of a release pin 130 that projects perpendicularly from an end surface 136 that runs transversely to the shaft longitudinal axis 132 of the shaft 134 of the release device 120.

  The proximal end of the release device 120 forms a handle 138.

  Preferably, the release member 122 is provided with a male screw, and a female screw corresponding to the male screw is provided in the release member opening 124.

  By screwing the release pin 130 into the release member opening 124, the connection insertion portion 56 is pushed out of the connection insertion portion receiver 54 in the direction defined by the arrow 140. The direction defined by arrow 140 is opposite to insertion direction 80. Under certain circumstances, this may require a large force. This is because the connecting projections must somewhat compress the connecting insert 56 so that the rib-shaped connecting projections 116 can emerge from the connecting element recesses 114.

  To facilitate the ejection of the connecting insert 56 from the connecting insert receiver 54, a recess 142 starting from the side connecting insert opening 98 is provided on the connecting insert receiver 54 just before the connecting element recess 114. The connection protrusion 116 can sink into the recess 142. Therefore, specifically, when the connection insertion portion 56 is pushed into the connection insertion portion receiver 54 and when the connection insertion portion 56 is pressed from the connection insertion portion receiver 54 using the release tool 120, the connection is made only. The protrusion may overcome the short protruding rib 144.

  The pull-out adjuster 46 is preferably configured in such a way that only the edges 86 and 88 of the connecting insert 56 can contact the connecting cone 38 and not the edges of the connecting base 52 at all. Accordingly, it is possible to prevent the connecting cone 52 from damaging the connecting cone 38. Preferably, the connecting base 52 is also formed of metal.

  In order to prepare a cavity on the femur for inserting the prosthetic stem 14, the first connecting element 60 should be identical to the corresponding connecting element on the file, which can be connected to the instrument handle 18 in particular. Can be.

  The described endoprosthetic hip system allows for careful extraction of the prosthetic stem 14 from the femur and, in particular, does not damage the connecting cone 38.

DESCRIPTION OF SYMBOLS 10 Intra-hip prosthesis system 12 Instrument 14 Artificial joint stem 16 Intra-hip joint prosthesis 18 Instrument handle 20 Rasp handle 22 Striking body 24 Striking surface 26 Instrument 28 End 30 Shaft 32 End 34 End 36 End 38 Connection cone 40 end face 42 end 44 neck section 46 pull-out adjuster 48 connecting body 50 connecting recess 52 connecting base 54 connecting insertion part receiving 56 connecting insertion part 58 end face 60 first connecting element 62 connecting protrusion 64 connecting protrusion longitudinal axis 66 recess 68 Second connection element 70 Connection element receiver 72 Fixing member 74 Pivot shaft 76 Locking projection 78 Side insertion opening 80 Arrow 82 Longitudinal axis 84 Lower insertion opening 86 Edge 88 Edge 90 Inner contour 92 Inner cone 94 Long Directional cone shaft 96 Narrow cross section 98 Side connection insertion portion receiving opening 100 Lower connection insertion portion receiving opening 102 Undercut 104 annular surface 106 connection device 108 latching or snap connection device 110 first connection element 112 second connection element 114 connection element recess 116 connection protrusion 118 opening surface 120 release device 122 release member 124 release member opening 126 length 128 thickness 130 Release pin 132 Shaft longitudinal axis 134 Shaft 136 End face 138 Handle 140 Arrow 142 Depression 144 Rib

Claims (37)

An endo-hip prosthesis system (10) including a medical device (12) for withdrawing a prosthetic stem (14) of an implanted endo-prosthesis (16) from a patient's femur,
The endoprosthetic hip prosthesis system wherein the medical device (12) has a connector (48) with a connection recess (50) for receiving a connection cone (38) protruding from the artificial joint stem (14). ,
The connecting body (48) includes a connecting base (52), and a connecting insert (56) that is housed in a connecting insert receiver (54) of the connecting base (52) and defines the connecting recess (50). A hip endoprosthesis system comprising:   The endoprosthesis system according to claim 1, wherein the connecting body (52) is formed of a metal harder than the connecting insert (56). .   Endoprosthesis system according to any one of the preceding claims, characterized in that the connecting body (52) is made of metal, in particular instrument steel. .   4. The endoprosthesis system according to claim 1, wherein the connecting insert (56) is made of plastic, in particular polyetheretherketone (PEEK), and / or polypropylene (PP). And / or formed from polyphenylene sulfone (PPSU).   The endoprosthesis system according to any one of the preceding claims, wherein the medical device (12) is connected to at least one first connecting element (60) for connecting to a device handle (18). A hip endoprosthesis system comprising:   The endoprosthetic prosthesis system according to claim 5, wherein the first connecting element (60) is configured in the form of a connecting projection (62).   The endoprosthesis system according to any one of the preceding claims, wherein the medical device (12) comprises a device handle (18), in particular configured in the form of a file handle (20). And a hip prosthesis system. The hip prosthesis system of claim 7, wherein
The instrument handle (18) includes a striker (22) with a strike surface (24); and the striker (22) is located or formed at a proximal end of the instrument handle (18). Or forming the proximal end of the instrument handle (18);
A hip joint prosthesis system, characterized in that:   9. The endoprosthesis system according to claim 7, wherein the instrument handle (18) is force-locked and / or positive-locked in a connection position with the at least one first connection element (60). An endo-hip prosthesis system comprising at least one second coupling element (68) for engaging in a manner.   The endoprosthesis system according to claim 9, wherein the at least one second connecting element (68) receives the at least one first connecting element (60). A hip endoprosthesis system characterized by the following configuration.   The endoprosthesis system according to claim 9 or 10, wherein the at least one second coupling element (68) is located or formed at a distal end (28) of the instrument handle (18). Alternatively, the distal end (28) of the instrument handle (18) is formed.   The endoprosthesis system according to any one of the preceding claims, wherein the connecting recess (50) locks the connecting cone (38) in a force-locked and / or positive-locked manner. An endoprosthetic hip prosthesis system configured to house.   The endoprosthesis system according to any one of the preceding claims, wherein the connecting recess (50) is relative to a longitudinal axis (82) defined by the connecting cone (38). Hip joint, characterized in that it has a lateral insertion opening (78) for inserting said connecting cone (38) into said connecting recess (50) in an insertion direction (80) running in a cross direction, in particular vertically. Endoprosthesis system.   14. The endoprosthesis system according to claim 13, wherein the connecting recess (50) opens in a direction transverse to the insertion opening (80), in particular in a direction perpendicular to the insertion opening (80). ), The endoprosthesis system for a hip joint.   The endoprosthesis system according to claim 14, wherein the side insertion opening (78) and the lower side when the connecting insert (56) is inserted into the connecting insert receiver (54). An endo-hip prosthesis system, wherein the connecting body (52) surrounds the connecting insert (56) such that the insertion opening (84) is freely accessible.   16. The endoprosthesis system according to any one of claims 13 to 15, wherein the connecting insert (56) connects the lateral insertion opening (78) and / or the lower insertion opening (84). Defining a defining edge or transition region.   The endoprosthesis system according to any one of the preceding claims, wherein the connecting recess (50) has an inner contour (90) at least in part in the form of an inner cone (92). Having an endoprosthesis within a hip joint.   The intra-hip prosthesis system of claim 17, wherein the inner cone (92) defines a longitudinal cone axis passing through the lower insertion opening (84). Prosthesis system.   19. The endoprosthetic hip prosthesis system according to claim 17 or 18, wherein the cross-section of the inner cone (92) increases in a direction toward the lower insertion opening (84). Thing system.   20. The endoprosthesis system according to any one of claims 17 to 19, wherein a narrow cross section (96) is formed between the inner cone (92) and the lower insertion opening (84). A prosthetic endoprosthesis system.   21. The endoprosthesis system according to any one of the preceding claims, wherein the connecting insert receiver (54) has a lateral connecting insert receiving opening (98) and a lower connecting insert receiving opening (54). 100). The endoprosthetic prosthesis system according to any one of the preceding claims.   The endoprosthesis system according to claim 21, wherein the lateral coupling insert receiving opening (98) is adapted to insert the coupling insert (56) into the coupling insert receiver (54). A prosthetic endoprosthesis system.   23. The endoprosthesis system according to claim 21 or 22, wherein the connecting insert receiver (54) passes a free cross section of the connecting insert receiver (54) to the lower connecting insert receiving opening (100). An undercut (102) formed by reduction in the direction of the hip joint prosthesis.   24. The endoprosthesis system according to any one of the preceding claims, wherein the connecting insert (56) is force-locked and / or positively locked in the connecting insert receiver (54). An endoprosthetic hip prosthesis system, wherein the prosthetic system is held in a fashionable manner.   25. The endoprosthesis system according to any one of the preceding claims, wherein the medical device (12) forces the connection insert (56) and the connection base (52) at a connection position. An endo-hip prosthesis system comprising a connecting device (106) for connecting in a locking and / or positive locking manner.   26. The endoprosthesis prosthesis according to claim 25, wherein the connection device (106) is configured in the form of a latching or snap-on connection device (108). system. The hip endoprosthesis system according to claim 25 or 26,
The connecting device (106) comprises first and second connecting elements (110, 112) formed on the connecting insert (56) on the one hand and on the connecting base (52) on the other hand; The first connection element and the second connection element are engaged in a force-locking and / or positive locking manner in the connection position;
A hip joint prosthesis system, characterized in that: 28. The hip prosthesis system of claim 27,
The first connection element (110) is configured in the form of a connection element recess (114); and the second connection element (112) is configured in the form of a connection protrusion (116);
A hip joint prosthesis system, characterized in that:   29. The endoprosthesis system according to claim 27 or 28, wherein the first connection element (110) and / or the second connection element (112) are provided with the lateral connection insert receiving opening (98) and And / or extending parallel or substantially parallel to the side insertion opening (78).   30. The endoprosthesis system according to any one of claims 27 to 29, wherein the connecting element (110) formed in the connecting insert receiver (54) on the connecting base (52). And a hip joint prosthesis system, wherein the hip joint prosthesis system is arranged or formed so as to face the lower connection insertion portion receiving opening (110).   31. The endoprosthesis system according to any one of claims 21 to 30, wherein the first connecting element (60) is on the connecting base (52) and the lower connecting insert receiving opening (100). The hip joint prosthesis system, wherein the endoprosthesis is positioned in a manner that is opposite or substantially opposite.   The endoprosthesis system according to any one of the preceding claims, wherein the connecting insert (56) is released from the connecting insert receiver (54) of the connecting base (52). An endoprosthetic hip prosthesis system characterized by a release device (120). 33. The endoprosthesis system of claim 32, wherein:
The release device (120) includes a release member (122);
The connecting body (52) includes a release member opening (124); and the releasing member (122) has a thickness greater than the thickness (128) of the connecting body (52) in the region of the release member opening (124). Also have a large length (126),
A hip joint prosthesis system, characterized in that:   34. The endoprosthesis system of claim 33, wherein the release member opening (124) is located or formed opposite the side coupling insert receiving opening (98). Hip endoprosthesis system.   35. The endoprosthesis system of claim 33 or claim 34, wherein the release member (122) is configured in the form of a release pin (130) protruding from the release device. Prosthesis system. 36. The hip endoprosthesis system according to any one of claims 33 to 35, wherein
The release member (122) comprises an external thread; and the release member opening (124) comprises an internal thread corresponding to the external thread;
A hip joint prosthesis system, characterized in that:   An endoprosthetic prosthesis system according to any of the preceding claims, characterized in that the prosthetic stem (14) of the endoprosthesis (16) has a projecting connecting cone (38). Hip prosthesis system.

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